Cheryl Denise Hagedorn

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146004722 Issued in IL

Practice address

306 Eckley Avenue
East Peoria, IL 61611

Phone

(309) 453-9423

NPI assigned

Aug 31, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386162253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 ECKLEY AVE",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112108",
            "telephone_number": "309-453-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 ECKLEY AVENUE",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "61611",
            "telephone_number": "309-453-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "CHERYL",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James T Gray, DDS
• Lori L Griffin, P.T.
• Perri Marie Grimm
• Wiktoria A Gruszka
• Xavier Gutierrez
• Jilian Elise Hammond, MSN, PMHNP-BC
• Lynn E Hanson, PT
• Lindsay Ryan Harms, M.S., L.C.P.C.
• Lucy Harris
• Bailey Hatfill

• Speech-Language Pathologist in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.